Dr Rachael McMillan is a musculoskeletal and emergency medicine researcher and senior clinician physiotherapist (PhD) in Emergency Department and Urgent Care settings. She is an early career researcher, three years post PhD, with an established track record conducting musculoskeletal research and collaborating with world experts in physiotherapy and clinical musculoskeletal research.
Dr McMillan successfully led the first randomised clinical trial (RCT) to investigate menopausal hormone therapy (MHT) and exercise as interventions for postmenopausal women with greater trochanteric pain syndrome (GTPS), which has positively influenced clinical practice worldwide.
The RCT (Cowan et al. 2022) conducted by Dr McMillan (Cowan) was published in The American Journal of Sports Medicine and has attracted multiple awards. Dr McMillan has won national and international awards for her research and is regularly invited to present on the topic of gluteal tendinopathy/GTPS in Australia and to a global audience.
What does an average working week look like for you?
It involves leading multiple clinical-based research projects, balancing teaching commitments in the School of Medicine, and working clinically as an Advanced Practice Physiotherapist in the Emergency Department and Urgent Care Centre at Barwon Health.
Tell us about your research interests and how they are evolving.
I’m passionate about this research because the results enable direct translation into clinical practice and can influence the way musculoskeletal conditions are managed across the world. My current focus is building a program of research that investigates the use of menopausal hormone therapy for managing tendon conditions in the postmenopausal population.
My research is directly related to my area of clinical practice: musculoskeletal and emergency medicine. My PhD investigated gluteal tendon and muscle adaptations in active populations and those with pain and included a collaborative project with the The Australian Ballet. I’m continuing to grow this body of research relating to tendinopathy and musculoskeletal medicine.
Previously I worked as a physiotherapist in both musculoskeletal and professional sport settings (including with the Australian National Women’s Football Teams and Melbourne Victory Women) and I’m now an Advanced Practice Physiotherapist in the Emergency Department and Urgent Care Centre at Barwon Health.
What have been some of the outcomes of the MHT trial?
My research has involved investigating MHT as an intervention for postmenopausal women with lateral hip pain (greater trochanteric pain syndrome/GTPS or gluteal tendinopathy). It was the first clinical trial worldwide to consider MHT for tendinopathy management and addressed a burdensome condition in the postmenopausal population.
Results of the published RCT showed MHT with exercise and education significantly reduces pain and improves function (better than the placebo therapy) for postmenopausal women when body mass index (BMI) is less than 25.
These findings have influenced the way clinicians manage tendon conditions for postmenopausal women worldwide. The results might also be generalisable to other tendinopathies in postmenopausal women and so I am now building a program of research regarding menopausal hormone therapy for tendinopathy.
Tell us about some of your collaborations.
I’ve been collaborating with a team of world-class researchers, creating a large multi-disciplinary team of researchers and clinicians who come together to deliver high quality projects.
I’m currently Lead Investigator on a new pilot randomised clinical trial which will investigate an alternative method of menopausal hormone therapy for managing an upper limb tendon condition in postmenopausal women. Barwon Health will be the primary site and this trial would not be possible without the wide range of expertise coming together to collaborate on the project. More to come on this in 2025!
